NTDs V.2.0: "blue marble health"--neglected tropical disease control and elimination in a shifting health policy landscape

Abstract

The concept of the neglected tropical diseases (NTDs) was established in the aftermath of the Millennium Development Goals. Here, we summarize the emergence of several new post-2010 global health documents and policies, and how they may alter the way we frame the world's major NTDs since they were first highlighted. These documents include a new Global Burden of Disease 2010 Study that identifies visceral leishmaniasis and food-borne trematode infections as priority diseases beyond the seven NTDs originally targeted by preventive chemotherapy, a London Declaration for access to essential medicines, and a 2013 World Health Assembly resolution on NTDs. Additional information highlights an emerging dengue fever pandemic. New United Nations resolutions on women and the non-communicable diseases (NCDs) have not yet embraced NTDs, which may actually be the most common afflictions of girls and women and represent a stealth cause of NCDs. NTDs also have important direct and collateral effects on HIV/AIDS and malaria, and there is now a robust evidence base and rationale for incorporating NTDs into the Global Fund to Fight AIDS, Tuberculosis, and Malaria. "Blue marble health" is an added concept that recognizes a paradoxical NTD disease burden among the poor living in G20 (Group of Twenty) and other wealthy countries, requiring these nations to take greater ownership for both disease control and research and development. As we advance past the year 2015, it will be essential to incorporate global NTD elimination into newly proposed Sustainable Development Goals.

Figure 1. The poor living among the wealthy.

Major areas of poverty in the G20 nations and Nigeria, where most of the world's NTDs occur (map prepared by Esther Inman). Figure originally appeared in “The Disease Next Door” by Peter Hotez, Foreign Policy, March 25, 2013, www.foreignpolicy.com. Information for Europe from Hotez PJ, Gurwith M. 2011. Europe's neglected infections of poverty. Int J Infect Dis 15: e611–9. Information for US and Mexico from Hotez PJ, Bottazzi ME, Dumonteil E, Valenzuela JG, et al. 2012. Texas and Mexico: sharing a legacy of poverty and neglected tropical diseases. PLOS Negl Trop Dis 6: e1497; Hotez PJ. 2012. Fighting neglected tropical diseases in the southern United States. BMJ 345: e6112; Hotez PJ. 2011. America's most distressed areas and their neglected infections: the United States Gulf Coast and the District of Columbia. PLOS Negl Trop Dis 5: e843; http://geo-mexico.com/?tag=economics&paged=2 accessed December 26, 2012; and http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0000256, accessed December 26, 2012. Information for India from http://mapsofindia.com/maps/india/poverty.html, accessed December 25, 2012. Information for China from Hotez PJ. 2012. Engaging a rising China through neglected tropical diseases. PLOS Negl Trop Dis 6: e1599. Information for Brazil from http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/LACEXT/EXTLACREGTOPPOVANA/0,,contentMDK:22416581~pagePK:34004173~piPK:34003707~theSitePK:841175,00.html, accessed December 26, 2012; Information for Indonesia from http://sedac.ciesin.columbia.edu/data/set/povmap-small-area-estimates-poverty-inequality/maps/5, accessed December 26, 2012. Information for South Africa from http://www.cepf.net/where_we_work/regions/africa/maputaland/ecosystem_profile/Pages/socioeconomic_context.aspx, accessed December 26, 2012. Information for Australia from http://www.abs.gov.au/ausstats/abs.nsf/Latestproducts/1362.7Feature%20Article1Mar%202011?opendocument, accessed December 31, 2012. Information for Gran Chaco region of Argentina from http://en.wikipedia.org/wiki/File:GranChacoApproximate.jpg, accessed January 4, 2013.

Figure 2. “The Blue Marble”—an international symbol of peace and healing—photographed by Astronauts, Eugene Cernan, Ronald Evans, and Jack Schmitt, December 7, 1972;

http://visibleearth.nasa.gov/view.php?id=55418 , accessed December 25, 2012.